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https://www.readbyqxmd.com/read/29137580/prevalence-and-predictors-of-persistent-post-surgical-opioid-use-a-prospective-observational-cohort-study
#1
N Stark, S Kerr, J Stevens
Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29058108/pre-admission-tsh-levels-predict-long-term-mortality-in-adults-treated-for-hypothyroidism
#2
Amit Akirov, Tzipora Shochat, Amir Shechvitz, Ilan Shimon, Talia Diker-Cohen, Eyal Robenshtok
CONTEXT: Limited data is available regarding the association between pre-admission thyroid function and prognosis of hospitalized patients treated for hypothyroidism. OBJECTIVE: Evaluate an association between thyroid stimulating hormone (TSH) levels and mortality in hospitalized levothyroxine-treated patients. DESIGN AND SETTING: Observational data of patients admitted to medical wards between 2011 and 2013. TSH levels obtained up to 180 days prior to admission were stratified as follows: low (≤0...
October 20, 2017: Endocrine
https://www.readbyqxmd.com/read/28971347/effects-of-the-personalized-recovery-oriented-services-pros-program-on-hospitalizations
#3
Candace White, Eric Frimpong, Steve Huz, Adrienne Ronsani, Marleen Radigan
Though the recovery model has been implemented widely in outpatient mental health settings, there are no large sample evaluations of recovery oriented psychiatric rehabilitation programs that address both serious mental illness (SMI) and co-occurring disorders (COD) using a more comprehensive Medicaid reimbursable approach. This study examined preliminary hospitalization outcomes, for adults with SMI and COD enrolled in the NYS Personalized Recovery Oriented Services (PROS) program. McNemar's chi-square test was used to examine changes in hospitalization rates from pre-PROS admission to post-PROS discharge in a sample of 12,006 adults discharged from PROS...
October 2, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28964298/implementation-of-a-perioperative-surgical-home-protocol-for-pediatric-patients-presenting-for-adenoidectomy
#4
Vidya T Raman, Dmitry Tumin, Joshua Uffman, Arlyne K Thung, Candice Burrier, Kris R Jatana, Charles Elmaraghy, Joseph D Tobias
INTRODUCTION: The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. METHODS: Eligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28957688/pre-admission-functional-decline-in-hospitalized-persons-with-dementia-the-influence-of-family-caregiver-factors
#5
Marie Boltz, Kyung Hee Lee, Tracy Chippendale, Rebecca L Trotta
Older adults with dementia are more likely than those who do not have dementia to be hospitalized. Admission functional (ADL) performance is a salient factor predicting functional performance in older adults at discharge. The days preceding hospitalization are often associated with functional loss related to the acute illness. An understanding of functional changes during this transition will inform interventions to prevent functional decline. This secondary analysis examined data from a study that evaluated a family educational empowerment model and included 136 dyads (persons with dementia and their family caregiver)...
September 21, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28935227/physiotherapy-education-and-training-prior-to-upper-abdominal-surgery-is-memorable-and-has-high-treatment-fidelity-a-nested-mixed-methods-randomised-controlled-study
#6
Ianthe Boden, Doa El-Ansary, Nadia Zalucki, Iain K Robertson, Laura Browning, Elizabeth H Skinner, Linda Denehy
OBJECTIVES: To (1) assess memorability and treatment fidelity of pre-operative physiotherapy education prior to elective upper abdominal surgery and, (2) to explore patient opinions on pre-operative education. DESIGN: Mixed-methods analysis of a convenience sample within a larger parallel-group, double-blinded, randomised controlled trial with concealed allocation and intention-to-treat analysis. SETTING: Tertiary Australian hospital. PARTICIPANTS: Twenty-nine patients having upper abdominal surgery attending pre-admission clinic within six-weeks of surgery...
September 1, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28927644/acute-kidney-injury-is-a-risk-factor-for-subsequent-proteinuria
#7
Sharidan K Parr, Michael E Matheny, Khaled Abdel-Kader, Robert A Greevy, Aihua Bian, James Fly, Guanhua Chen, Theodore Speroff, Adriana M Hung, T Alp Ikizler, Edward D Siew
Acute kidney injury (AKI) is associated with subsequent chronic kidney disease (CKD), but the mechanism is unclear. To clarify this, we examined the association of AKI and new-onset or worsening proteinuria during the 12 months following hospitalization in a national retrospective cohort of United States Veterans hospitalized between 2004-2012. Patients with and without AKI were matched using baseline demographics, comorbidities, proteinuria, estimated glomerular filtration rate, blood pressure, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker (ACEI/ARB) use, and inpatient exposures linked to AKI...
September 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28888692/canadian-study-of-health-and-aging-clinical-frailty-scale-does-it-predict-adverse-outcomes-among-geriatric-trauma-patients
#8
Annie Cheung, Barbara Haas, Thom J Ringer, Amanda McFarlan, Camilla L Wong
BACKGROUND: The Canadian Study of Health and Aging Clinical Frailty Scale (CFS) and the laboratory Frailty Index (FI-lab) are validated tools based on clinical and laboratory data, respectively. Their utility as predictors of geriatric trauma outcomes is unknown. Our primary objective was to determine whether pre-admission CFS is associated with adverse discharge destination. Secondary objectives were to evaluate the relationships between CFS and in-hospital complications and between admission FI-lab and discharge destination...
November 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28869718/prevalence-and-causes-of-preoperative-anaemia-in-elective-major-surgery-patients
#9
Frank S Hong, Nicole Sieradzki, Claire Pollock, Faye Nasra, Allison Mo, Abbey Willcox, Leonid Churilov, Wai Khoon Ho, Carole Smith
BACKGROUND: Preoperative anaemia is associated with increased morbidity and mortality in surgical patients. Recent national patient blood management guideline recommended screening surgical patients for anaemia and in particular iron deficiency anaemia, without reference to the prevalence of anaemia or iron deficiency anaemia in this patient population. AIMS: To establish the prevalence and cause of preoperative anaemia in elective major surgery patients. METHODS: Patients attending the anaesthetic pre-admission clinics from 1 July 2013 to 30 June 2014 prior to their major elective surgery in our institution were screened for anaemia and iron deficiency by measuring full blood count, iron studies and C-reactive protein...
September 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28869294/beta-blocker-therapy-is-not-associated-with-mortality-after-intracerebral-hemorrhage
#10
M Sykora, J Putaala, A Meretoja, T Tatlisumak, D Strbian
BACKGROUND: Beta-blocker therapy has been suggested to have neuroprotective properties in the setting of acute stroke; however, the evidence is weak and contradictory. We aimed to examine the effects of pre-admission therapy with beta-blockers (BB) on the mortality following spontaneous intracerebral hemorrhage (ICH). METHODS: Retrospective analysis of the Helsinki ICH Study database. RESULTS: A total of 1013 patients with ICH were included in the analysis...
September 4, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28868159/the-effects-of-residential-dual-diagnosis-treatment-on-alcohol-abuse
#11
Stephen J Schoenthaler, Kenneth Blum, Lyle Fried, Marlene Oscar-Berman, John Giordano, Edward J Modestino, Rajendra Badgaiyan
This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co-occurring alcohol and mental health disorders. The Addiction Severity Index was administered at admission and at one, six, and 12 months after discharge. Repeated measures analysis showed the intoxication rate per month stabilized between months six and 12 with 68% still in remission and an 88% mean reduction from baseline (F = 519, p < .005). A comparison between patients with and without weekly relapse produced significant differences in hospitalization (odds ratio 11...
July 2017: Journal of Systems and Integrative Neuroscience
https://www.readbyqxmd.com/read/28864172/do-patients-understand-the-role-of-resident-physicians-in-the-operating-room-a-survey-of-gynaecology-patients
#12
Arielle Cantor, Catherine Flood, Savanna Boutin, Shauna Regan, Sue Ross
OBJECTIVE: Studies from disciplines outside gynaecology have found that most patients do not understand the clinical responsibilities allocated to physicians-in-training. No research on this topic has been published in gynaecology, despite litigation against gynaecological surgeons regarding the role of residents in surgery. The goal of this research was to explore what gynaecological surgery patients understand about the role of resident doctors. METHODS: A questionnaire was distributed to female patients in gynaecological surgery pre-admission clinics in Edmonton, Alberta...
August 29, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28843663/risk-factors-and-outcomes-of-critically-ill-patients-with-acute-brain-failure-a-novel-end-point
#13
Tarun D Singh, John C O'Horo, Ognjen Gajic, Amra Sakusic, Courtney N Day, Jay Mandrekar, Rahul Kashyap, Dereddi Raja Shekar Reddy, Alejandro A Rabinstein
OBJECTIVE: To determine the incidence, risk factors and outcomes of acute brain failure (ABF) in a mixed medical and surgical cohort of critically ill patients and its effect on ICU & hospital mortality. DESIGN: Observational electronic medical record (EMR) based retrospective cohort study of critically ill patients admitted to the ICU between 2006 and 2013. SETTING: Tertiary academic medical center. PATIENTS: Consecutive adult (>18years) critically ill patients admitted to medical and surgical ICUs...
August 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28836712/religious-coping-in-patients-with-severe-substance-use-disorders-receiving-acute-inpatient-detoxification
#14
Morgan M Medlock, David H Rosmarin, Hilary S Connery, Margaret L Griffin, Roger D Weiss, Sterling L Karakula, R Kathryn McHugh
BACKGROUND AND OBJECTIVES: Religious coping, one of the most widely studied components of spirituality among psychiatric populations, has rarely been addressed in patients with severe substance use disorders (SUD). The aim of our study was to elucidate whether religious coping is related to symptom expression and mutual-help participation. METHODS: Self-reported religious coping was assessed in individuals sequentially admitted to a private psychiatric hospital for inpatient detoxification...
October 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28833408/suicide-crisis-syndrome-mediates-the-relationship-between-long-term-risk-factors-and-lifetime-suicidal-phenomena
#15
Lisa Janet Cohen, Firouz Ardalan, Zimri Yaseen, Igor Galynker
In recent years, there has been growing attention to the distinction between acute and long-term suicidal risk factors. We have previously characterized an acute, negative affect state, termed the suicide crisis syndrome (SCS), as a marker of near-term suicidal risk. Here, we test whether documented long-term risk factors (i.e., trait vulnerabilities), including perfectionism, impulsivity, chronic substance abuse, insecure attachment, poor social support, and childhood trauma, associate to suicidal phenomena through a pathway of the SCS...
August 22, 2017: Suicide & Life-threatening Behavior
https://www.readbyqxmd.com/read/28791772/functional-trajectories-of-older-patients-admitted-to-an-acute-care-unit-for-elders
#16
Andreina D'Onofrio, Christophe Büla, Eve Rubli, Fabiana Butrogno, Diane Morin
AIMS AND OBJECTIVES: To describe the functional trajectories of older medical inpatients and to identify factors associated with overall and in-hospital functional decline. BACKGROUND: Functional decline during a hospital stay is an important clinical outcome because independence remains a major determinant of older persons' quality of life and health care demands. DESIGN AND METHODS: Participants (n = 189) were admitted to the Acute Care Unit for Elders of a Swiss academic hospital and were aged 65 years and older...
August 9, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28747964/effect-of-preadmission-metformin-use-on-clinical-outcome-of-acute-respiratory-distress-syndrome-among-critically-ill-patients-with-diabetes
#17
Yong Suk Jo, Sun Mi Choi, Jinwoo Lee, Young Sik Park, Chang-Hoon Lee, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Sang-Min Lee
BACKGROUND: Acute respiratory distress syndrome (ARDS) is related to high mortality and morbidity. There are no proven therapeutic measures however, to improve the clinical course of ARDS, except using low tidal volume ventilation. Metformin is known to have pleiotropic effects including anti-inflammatory activity. We hypothesized that pre-admission metformin might alter the progress of ARDS among intensive care unit (ICU) patients with diabetes mellitus (DM). METHODS: We performed a retrospective cohort study from January 1, 2005, to April 30, 2005 of patients who were admitted to the medical ICU at Seoul National University Hospital because of ARDS, and reviewed ARDS patients with DM...
July 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28733996/long-term-effectiveness-of-the-preoperative-smoking-cessation-programme-at-western-health
#18
Hugh Taylor, Amalia Karahalios, David Bramley
BACKGROUND: Smoking is associated with adverse effects in the perioperative period, including elevated risk of death. The perioperative period provides an opportunity to engage with patients who are smokers to encourage smoking cessation, often referred to as a 'teachable moment'. We developed a smoking intervention model for the pre-admission clinic (PAC) at Western Health, Victoria, Australia. This case series aimed to assess the impact of the smoking intervention model, which is standard of care, on the participant's smoking habits over four time points...
July 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28666578/outpatient-beta-blockers-and-survival-from-sepsis-results-from-a-national-cohort-of-medicare-beneficiaries
#19
Kathleen E Singer, Courtney E Collins, Julie M Flahive, Allison S Wyman, M Didem Ayturk, Heena P Santry
BACKGROUND: Elderly Americans suffer increased mortality from sepsis. Given that beta-blockers have been shown to be cardioprotective in critical care, we investigated outpatient beta-blocker prescriptions and mortality among Medicare beneficiaries admitted for sepsis. METHODS: We queried a 5% random sample of Medicare beneficiaries for patients admitted with sepsis. We used in-hospital and outpatient prescription drug claims to compare in-hospital and 30-day mortality based on pre-admission beta-blocker prescription and class of beta-blocker prescribed using univariate tests of comparison and multivariable logistic regression models and another class of medications for control...
October 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28651583/challenges-and-potential-improvements-in-the-admission-process-of-patients-with-spinal-cord-injury-in-a-specialized-rehabilitation-clinic-an-interview-based-qualitative-study-of-an-interdisciplinary-team
#20
Fabian Röthlisberger, Stefan Boes, Sara Rubinelli, Klaus Schmitt, Anke Scheel-Sailer
BACKGROUND: The admission process of patients to a hospital is the starting point for inpatient services. In order to optimize the quality of the health services provision, one needs a good understanding of the patient admission workflow in a clinic. The aim of this study was to identify challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic from the perspective of an interdisciplinary team of health professionals...
June 26, 2017: BMC Health Services Research
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